Post Op - screw removal

Hello everyone,

I've been reading all these posts and wanted to get some opinions on my situation.

I fractured my fibula and dislocated my left ankle exactly 7wks. and three days ago - yes I'm counting!  Beyond horrible situation..

I have had two surgeries to date, first to repair the break with a plate and 8 screws, two of the screws are long ones that go thru both the fibula and tibia and six other small ones.  The second surgery was almost three weeks in, to remove bone fragments in my ankle, this was most unpleasant and painful for quite some time.

I am scheduled to have the two long screws removed on Sept. 13th, but when I took the air cast off this morning to wash and air my foot, I can see two bumps over my ankle.  When I check the xrays (I took pictures of all of my xrays) and count where the staples were, the bumps seem to be lower than where the long screws seem to be located.  I'm no Dr. but now I'm starting to be concerned.  The bumps are not particularly sore nor do they feel overly hard.

Can anyone tell me whether I should be overly worried and should I call the Dr.?  I'm wondering if they are making their way out, which creeps me out...

I would appreciate any comments or wisdom from someone who has maybe gone thru something similar ... thank you

Hello all. I read over all the posts and they were helpful, but I wanted to tell my story and see your thoughts. I am a 30 year old female. I was ran over by a car and had Open Reduction Internal Fixation Surgery on my left medial ankle in 8/2011 which resulted in 2 large screws, a few small screws ( I cant recall how many) and one plate. As a result from the surgery, I got MRSA and then had to get anther I&D (incision and drainage) sugery later in 8/2011 to clear out MRSA. An intravenous PIC line was put in where Vancomycin was administered for a month to clear out infection. This all led me to have a large open wound that I had to keep open post surgery then pack wet to dry with gauze and saline for 2 months until the tissue grew back in. Once wound had closed (which is rather large), I did physical therapy for 6 months after and got most of my mobility and range of motion back. I now have a depressed contracted adherent scar over my left medial malleolus. Although the surrounding tissue is supple and mobile, and my left leg peripheral pulses are full, the impression of the scar is poor quality. I saw a plastic surgeon in 2012 concerned of the location of the scar who told me that the scar was over a bony prominence that will be prone to breakdown in the future. He said that light trauma could damage the skin and result in bone exposure. He said it would be easier to remove the scar and resurface the mallelus with a proximally based rotational flap while adjacent tissue is healthy and I am young with good blood supply. Although, he did also say complicatons come with flap coverage which include infection, skin loss, and need for more complex surgery to gain optimum closure. The look of the scar is not what is bothering me. What concerns me is that it is prone to breakdown. Over the last few years there has been swelling on a regular basis within my ankle, especially after working out. I know this is common and did not bother me much until I started to get pain. In past 2 years, if standing on it for a long period of time or engaging in a very strenous activiity, I will have sharp shooting pains that only last a few minutes (which I was fine with and dealt with). I have always been somewhat active. I currently go to spin class 5 days a week. I figure this would be better than running as its not as high impact on ankle. Every once in awhile, I have had a dull aching pain in my ankle. If I do intense weight bearing activity for long periods of time, it aches and swells. I have also noticed a little bump which appears to be the back of the screw possibly pushing out. On 3/15/2016, I went to see an orthopedic surgeon (5 years after surgery) to get a follow up XRAY to see if there was any misplacement of hardware or anything he would see immediatly wrong. The surgeon said he does not see much movement of screws, but could feel the back of the screw through the scar, which is okay. He does not think it will puncture the skin in future but can't say for sure. He recommended that I get hardware taken out eventually if I want pain to discontinue, but said its up to me. From what I have read sometimes that does not even happen. He also suggested if I ever got the screws taken out to have him and plastic surgeon work concurrently in operating room to insure that the wound is closed appropriately for best healing because of the poor quality of the scar and all the trauma there has been to that area in the past. Present day, I feel like the screw as moved even more as the bump is more prominent and it looked darker in the area, as if you can see coloring of screw. However, this is no bruising around the area. I don't know what to do. I am so paranoid I will have a MRSA issue again or I am scared that if I am cut open again, my wound is not going to heal correctly and then I will need more complex surgery to full closure. Please let me know if anyone has had any issue such as myself and what they think I should do.  Thank you.